Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Independence Center

Organization Psychiatry Physician · NPI 1083054787

Independence Center is a Psychiatry Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2013.

Licensed in
MO
In the registry since
2013

Practice location Address checks out

4219 Laclede Ave
Saint Louis, MO 63108-2814
Phone: (314) 880-5415
Fax: (314) 880-5468
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X (MO)

Record details

NPI number1083054787
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patricia Holmes — Executive Director · (314) 880-5415
Other names Independence Center Health Group; Midwest Psychiatry
NPI enumeratedJune 27, 2013
Last updated in NPPESJune 27, 2022
Certification dateJune 27, 2022
Mailing address4245 Forest Park Ave, Saint Louis, MO 63108-2810

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